The psychoneuroimmunology of music: modulation of psychological state, stress levels and immune response through participatory interventions

Research into the health benefits of music has rapidly expanded over the last decade with recent studies showing early evidence of the ability of music to alter biomarkers of the neurochemical and neuroendocrine systems. However, it is not clear to what extent music can alter the response of the immune system. This thesis explores psychoneuroimmunological responses to music, in particular focusing on how participatory music interventions can modulate inflammatory responses. The biomarkers investigated include cortisol, a neuroendocrine stress marker, a range of pro- and anti-inflammatory cytokines within the immune system, the social bonding hormone oxytocin and the neuropeptide beta-endorphin. Study 1 involved a six-week drumming intervention for mental health service users, and showed that drumming was associated with short-term increases in positive affect and cytokine activity and reductions in cortisol, and longitudinal improvements in depression, mental and social wellbeing, and reduced pro-inflammatory response. Study 2 replicated study 1 with a control group, showing comparable results at 6 weeks but also showing that if the intervention is extended to 10 weeks, there are also reductions in anxiety and all results are then maintained for 3 months following the end of the intervention. Study 3 aimed to explore the mechanisms of these effects in more detail. A randomised control trial comparing group drumming to three different control conditions showed that drumming, unlike the control conditions, leads to changes in a range of moods and emotions and the accompanying biological responses show signs of being associated with these emotions rather than with the physical parameters of group drumming. Study 4 extended the work of the previous mental health studies to explore how participatory music interventions can interact with the psychobiology of both mental health and physical health by studying patients affected by a chronic disease: cancer. A single session of group singing was found to be associated with reduced levels of cortisol, increased cytokine activity and, surprisingly, reduced levels of both beta-endorphin and oxytocin, again with associations between biological responses and emotions. Given the prevalence of mental health conditions such as depression, either as a primary or secondary diagnosis, and evidence that such conditions are associated with heightened inflammation, participatory music interventions could offer novel opportunities for managing mental health and optimising immune function in patients

Happiness predicts compliance with preventive health behaviours during Covid-19 lockdowns

To combat the public health crisis of Covid-19, governments and public health officials have been asking individuals to substantially change their behaviours for prolonged periods of time. Are happier people more willing to comply with such measures? Using independent, large-scale surveys covering about 79,000 adult respondents across 29 countries, including longitudinal data from the UK, we find that life satisfaction predicts compliance with preventive health behaviours during Covid-19 lockdowns, especially the number of weekdays stood at home (β = 0.02, p 0.10, 2 on a 0-to-10 scale). We explore risk-avoidance and pro-social motivations for this relationship, and find suggestive evidence that people who are older or have certain medical preconditions seem to be behave in line with risk-avoidance, whereas motivations of people who are less at risk of Covid-19 seem more mixed. While it is difficult to estimate the relationship between life satisfaction and compliance behaviour due to potential confounders and unobserved heterogeneity, our findings suggest that life satisfaction is important, both for complying with preventive health measures and as a policy end in itself

Are happier people more compliant? Evidence from lockdowns

What makes people more likely to comply with a lockdown? Christian Krekel (LSE), Sarah Swanke (LSE), Jan-Emmanual De Neve (Oxford University) and Daisy Fancourt (UCL) drew on large-scale surveys and found that happiness predicts compliance, over and beyond a wide range of people’s other observable characteristics. Older and less healthy people seem to be predominantly motivated by risk-avoidance, whereas the motivations of younger ones seem more mixed. People are less likely to follow the rules if they were unhappy

A local community course that raises mental wellbeing and pro-sociality

Although correlates of mental wellbeing have been extensively studied, relatively little is known about how to effectively raise mental wellbeing in local communities by means of intervention. We conduct a randomised controlled trial of the "Exploring What Matters" course, a scalable social-psychological intervention aimed at raising general adult population mental wellbeing and pro-sociality. The manualised course is run by non-expert volunteers in their local communities and to date has been conducted in more than 26 countries around the world. We find that it has strong, positive causal effects on participants' selfreported subjective wellbeing (life satisfaction increases by about 63% of a standard deviation) and prosociality (social trust increases by about 53% of a standard deviation) while reducing measures of mental ill health (PHQ-9 and GAD-7 decrease by about 50% and 42% of a standard deviation, respectively). Impacts seem to be sustained two months post-treatment. We complement self-reported outcomes with biomarkers collected through saliva samples, including cortisol and a range of cytokines involved in inflammatory response. These move consistently into the hypothesised direction but are noisy and do not reach statistical significance at conventional level

Happiness predicts compliance with preventive health behaviours during Covid-19 lockdowns

To combat the public health crisis of Covid-19, governments and public health officials have been asking individuals to substantially change their behaviours for prolonged periods of time. Are happier people more willing to comply with such measures? Using independent, large-scale surveys covering about 79,000 adult respondents across 29 countries, including longitudinal data from the UK, we find that life satisfaction predicts compliance with preventive health behaviours during Covid-19 lockdowns, especially the number of weekdays stood at home (β=0.02, p0.10, 2 on 0-to-10 scale). We explore risk-avoidance and pro-social motivations for this relationship, and find suggestive evidence that people who are older or have certain medical preconditions seem to be behave in line with risk-avoidance, whereas motivations of people who are less at risk of Covid-19 seem more mixed. While it is difficult to estimate the relationship between life satisfaction and compliance behaviour due to potential confounders and unobserved heterogeneity, our findings cautiously suggest that life satisfaction is important, both for complying with preventive health measures and as a policy end in itself

How does the process of group singing impact upon people affected by cancer? A grounded theory study

OBJECTIVE: This study aimed to build an understanding of how the process of singing impacts on those who are affected by cancer, including patients, staff, carers and those who have been bereaved. DESIGN: A qualitative study, informed by a grounded theory approach. SETTING AND PARTICIPANTS: Patients with cancer, staff, carers and bereaved who had participated for a minimum of 6 weeks in one of two choirs for people affected by cancer. METHODS: 31 participants took part in Focus Group Interviews lasting between 45 min and an hour, and 1 participant had a face-to-face interview. FINDINGS: Four overarching themes emerged from the iterative analysis procedure. The overarching themes were: building resilience, social support, psychological dimensions and process issues. Following further analyses, a theoretical model was created to depict how building resilience underpins the findings. CONCLUSION: Group singing may be a suitable intervention for building resilience in those affected by cancer via an interaction between the experience and impact of the choir

When to release the lockdown: a wellbeing framework for analysing costs and benefits

In choosing when to end the lockdown, policy-makers have to balance the impact of the decision upon incomes, unemployment, mental health, public confidence and many other factors, as well as (of course) upon the number of deaths from COVID-19. To facilitate the decision it is helpful to forecast each factor using a single metric. We use as our metric the number of Wellbeing-Years resulting from each date of ending the lockdown. This new metric makes it possible to compare the impact of each factor in a way that is relevant to all public policy decisions

The neurological consequences of contracting covid-19

Since the first confirmed case in Wuhan, China on December 31, 2019, the novel coronavirus (SARS-CoV-2) has spread quickly, infecting 165 million people as of May 2021. Since this first detection, research has indicated that people contracting the virus may suffer neurological and mental disorders and deficits, in addition to the respiratory and other organ challenges caused by COVID-19. Specifically, early evidence suggests that COVID-19 has both mild (e.g., loss of smell (anosmia), loss of taste (ageusia), latent blinks (hete-rophila), headaches, dizziness, confusion) and more severe outcomes (e.g., cognitive impairments, seizures, delirium, psychosis, strokes). Longer-term neurological challenges or damage may also occur. This knowledge should inform clinical guidelines, assessment, and public health planning while more systematic research using biological, clinical, and longitudinal methods provides further insights

Preliminary report from the World Health Organisation Chest Radiography in Epidemiological Studies project.

Childhood pneumonia is among the leading infectious causes of mortality in children younger than 5 years of age globally. Streptococcus pneumoniae (pneumococcus) is the leading infectious cause of childhood bacterial pneumonia. The diagnosis of childhood pneumonia remains a critical epidemiological task for monitoring vaccine and treatment program effectiveness. The chest radiograph remains the most readily available and common imaging modality to assess childhood pneumonia. In 1997, the World Health Organization Radiology Working Group was established to provide a consensus method for the standardized definition for the interpretation of pediatric frontal chest radiographs, for use in bacterial vaccine efficacy trials in children. The definition was not designed for use in individual patient clinical management because of its emphasis on specificity at the expense of sensitivity. These definitions and endpoint conclusions were published in 2001 and an analysis of observer variation for these conclusions using a reference library of chest radiographs was published in 2005. In response to the technical needs identified through subsequent meetings, the World Health Organization Chest Radiography in Epidemiological Studies (CRES) project was initiated and is designed to be a continuation of the World Health Organization Radiology Working Group. The aims of the World Health Organization CRES project are to clarify the definitions used in the World Health Organization defined standardized interpretation of pediatric chest radiographs in bacterial vaccine impact and pneumonia epidemiological studies, reinforce the focus on reproducible chest radiograph readings, provide training and support with World Health Organization defined standardized interpretation of chest radiographs and develop guidelines and tools for investigators and site staff to assist in obtaining high-quality chest radiographs